Professional article / Stručni članak
Maja Karić¹,², Sara Bezak², Melita Kukuljan¹,², Kurtović Branka³, Ana Božanić⁴,⁵, Boris Bezak¹,²
¹ Faculty of Health Studies, University of Rijeka, Department of Radiologic Technology, Rijeka, Croatia
² Clinical Hospital Centre Rijeka, Clinical Institute of Radiology, Rijeka, Croatia
³ Clinical Hospital Centre Rijeka, Clinic for Surgery, Rijeka, Croatia
⁴ Clinical Hospital Centre Rijeka, Department of Medical Physics and Radiation Protection, Rijeka, Croatia
⁵ Faculty of Medicine, University of Rijeka, Department of Medical Physics and Biophysics, Rijeka, Croatia
Corresponding author: Maja Karić,
Abstract
Extracorporeal membrane oxygenation (ECMO) is a form of temporary circulatory support in patients with impaired heart and / or lung function, in whom conventional methods of treatment have been exhausted. ECMO support does not treat the underlying pathology, but allows oxygenation and perfusion of vital organs until complete recovery or as a destination therapy for heart and / or lung transplantation. It is an integral part of modern intensive care for patients with severely impaired cardiac and / or respiratory function. Medical staff involved in the treatment and monitoring of patients on ECMO support should be familiar with the basics of the ECMO system, in accordance with the workplace and with approach to the patient on ECMO support. A radiologist who performs a radiological examination in such a patient requires cooperation with the anaesthesiology team and the team of perfusionists, so that the basic conditions for performing the examination are met and the examination is successfully performed. The aim of this paper is to acquaint radiological technologists with the approach to the patient on ECMO support and to present the experiences of the Radiology Department at Clinical Hospital Centre Rijeka in performing radiological examinations on such patients. Data are collected through hospital databases and are related to the demographic characteristics of patients and indications for performing computed tomography (CT) examinations. Patients were selected according to the type of ECMO support and according to the region of interest for performing a CT scan in the period from 1st January 2017 to 15th August 2019.
Keywords: Extracorporeal membrane oxygenation, perfusion, computed tomography, radiological examinations.
Sažetak
Izvantjelesna membranska oksigenacija (Extracorporeal membrane oxygenation - ECMO) je oblik privremene cirkulatorne potpore u bolesnika s narušenom funkcijom srca i/ili pluća, kod kojih su konvencionalne metode liječenja iscrpljene. ECMO potpora ne liječi osnovnu patologiju, nego omogućuje oksigenaciju i perfuziju vitalnih organa do potpunog oporavka ili kao destinacijska terapija prema transplantaciji srca i/ili pluća. Sastavni dio modernog intenzivnog liječenja bolesnika s teško oštećenom srčanom i/ili respiratornom funkcijom. Medicinsko osoblje uključeno u liječenje i monitoring bolesnika na ECMO potpori treba biti upoznato s osnovama ECMO sustava, sukladno radnom mjestu te sa pristupom bolesniku na ECMO potpori. Radiološki tehnolog koji izvodi radiološku pretragu kod takvog bolesnika treba suradnju s anesteziološkim timom i timom perfuzionista, kako bi osnovni uvjeti za izvođenje pretrage bili zadovoljeni te pretraga uspješno izvedena. Cilj ovog rada je upoznati radiološke tehnologe s pristupom bolesniku na ECMO potpori te prenijeti iskustva Kliničkog zavoda za radiologiju, Kliničkog bolničkog centra Rijeka (KBC), u izvođenju radioloških pretraga kod takvih bolesnika. Informacije prikupljene iz bolničkih baza podataka odnose se na demografske karakteristike bolesnika i indikacije za izvođenje pregleda kompjutoriziranom tomografijom (CT). Bolesnici su selektirani prema vrsti ECMO potpore i prema regiji od interesa za izvođenje CT pretrage u periodu od 1.1.2017. do 15.08.2019. godine.
Ključne riječi: izvantjelesna membranska oksigenacija, perfuzija, kompjutorizirana tomografija, radiološke pretrage.
